1. Field of the Invention
The present invention is related to a composition for the treatment of articular cartilage damage or loss or defect.
2. Description of the Prior Art
The articular cartilage damage induces pain in the articular region, fault of the articular movement, etc., and lowers the quality of life as well as productivity. Particularly, it is difficult to treat completely the articular cartilage damage since the natural healing power is very low and it is connected to the damage to the entire articulation as it is progressed continuously once it occurs.
The methods of treatment of articular cartilage damage developed up to the present time include chondroplasty, osteochondral, transplantation, autologous chondrocyte transplantation, etc.
Chondroplasty is the most generally used method among the above-described methods. The arthroscopic operation which is the representative method is a method in which diagnosis and operation may be performed simultaneously while magnifying and observing inside of the articulation through a TV monitor by inserting an arthroscope, on which a small-sized camera is mounted, into the articular cavity through a small hole of less than 1 cm.
The above method is advantageous in that it is possible to reduce pain and burden of a patient since it is not necessary to have a direct incision of articulation and it is possible to cure immediately after minor damages to tissues are observed through the arthroscope. However, this chondroplasty is not satisfactorily effective in view of its functional aspects since the fibro-cartilage, not hyaline cartilage that is necessary for the articulation actually, is produced mainly.
In the meantime, osteochondral transplantation is a method of producing hyaline cartilage by collecting both of the cartilage and sub-cartilage portions produced already in the normal section of a patient and transplanting them in the damaged cartilage section by making holes properly. This method has been successful in some patients. However, this method may not be said to be a perfect treatment method because of a problem of having cracks between the transplanted portion and original tissues, and is not a general method in that it may be applied to only the patients who are able to be subject to autologous transplantation. And the above method may not be operated if the damaged portion is large since the donated portion is limited, and it is likely that complications occur in the donated portion. Also, the process of operation is comparatively complicated, and sometimes it is not possible to perform arthroscopic operation. In other words, the above method has weaknesses such as a new pain in the donated portion and may incur complications such as a slow rehabilitation including pain, fracture, bleeding, and scar after operation.
Autologous chondrocyte transplantation that has been started to be employed recently is a method of filling the cartilage portion damaged by proliferation of these cells by obtaining chondrocytes from cartilage tissues collected from the normal portion of a patient, culturing and growing them as much as they are needed externally, securing a space by using periosteum and injecting them to the damaged portion of cartilage along with the culture medium.
Compared to the osteochondral transplantation method in which already produced cartilage tissues are injected to the damaged portion, there is a more possibility of reproducing hyaline cartilage as the transplanted portion is fused comparatively well with the normal portion since the damaged portion is filled with transplanted chondrocytes as they are proliferated directly in the damaged portion. However, there are still pain, after effects, and economical burden of a patient eventually due to the operation of twice and the process of operation is also complicated and difficult since it is necessary to perform operation when collecting chondrocytes and when transplanting those cultured externally are transplanted to the portion of articular cartilage damage.
And there are problems with chondrocytes in that it takes a considerable amount of time until as much as the cells that are necessary for transplantation during external culturing of cells are obtained as the proliferation and growth of the, cells collected are not active since the chondrocytes collected are obtained from fully grown adults in most cases; the treatment itself could not be accomplished if the cells lose the ability to proliferate at all; and the form of expression of cells is changed since chondrocytes are cultured externally. And it is of concern that the life of cartilage made by culturing again fully grown cells would not be long. And in case of the second operation, complications such as pain, scar, etc. after operation are inevitable since it is necessary to perform a serious incision since no arthroscopic operational methods have been developed yet.
It has been reported that there has been a method of obtaining mesenchymal stem cells (MSCs) that are precursor cells of chondrocytes and osteoblasts from mesenchymal tissues such as autologous bone marrows, muscles, skin, etc., proliferating them ex vivo, and injecting them into the portion of articular cartilage damage together with polymers.
It is shown that the cell proliferation ability in the method of treatment of cartilage damage by using mesenchymal stem cells obtained from grown individuals as described in the above is somewhat higher than that of the autologous chondrocyte transplantation method since more undifferentiated cells are obtained and cultured ex vivo. However, the above-described method still shows a weak ability to proliferate cells for the treatment of various ways of cartilage damage fully. Also, the above-described method is required to have a difficult process of collection of bone marrows, and is limited in that construction of an infrastructure such as bone marrow storage banks, etc. is weak.
As described in the above, the methods of treatment of articular cartilage damage developed up to the present time have been problematic in view of their operational processes and effects.